Tuesday Structured Recovery Evenings are suspended until 12th September 2017

Overcoming Driving Phobia

Phobias are very common - experts believe that one
person in ten is affected by a phobia at some time in their life - and driving
phobia is one of the most common. It can be a serious handicap, especially
for people who need to drive for a living, or who need to get to work by
car.

One Anxiety Care client had to give up his small
transport business when driving phobia struck.

Another held onto her job, but only because
her husband drove her there and back, while she sat trembling in the
back of the car with a coat over her head.

WHAT EXACTLY IS A PHOBIA?

Phobias are fears. Fear is a normal part of life,
and there are many things in life which can be dangerous or painful - such
as wasps, muggers, car crashes and having operations. Anyone might be afraid
of such things - or at least anxious about them. This is normal. Sensible
people take precautions to avoid being hurt or injured by things that are
genuinely dangerous.

In this sense, anxiety is very useful. It warns
you when danger is threatening. Severe anxiety - fear - can also be useful.
When we find ourselves in a situation of real danger - like being faced
by a robber in a dark alley - the fear reaction is just what we need.

It releases adrenaline and other chemicals into
our blood, and these speed up our heartbeat, sharpen our senses and heighten
our physical powers. These changes prepare us for what is called ‘flight
or fight’ - either to fight for our lives, or to run for them.

A phobia is a disorder in which the body reacts
in exactly the same way, and we experience exactly the same feelings of
anxiety and fear - but in situations where there is absolutely no need for
‘flight or fight’. It is as if our body and mind have lost all sense of
proportion, and internally scream ‘danger!’ at the least little thing -
like crossing a footbridge, encountering a cat, or driving across town.
But no matter how harmless the feared thing may be, for a phobic person the
fear reaction is every bit as real as if the cause was really life threatening.
People with phobias usually realise all too well that their reaction is
irrational, but this makes no difference to its effect.

The level of the symptoms that people with phobias
experience varies a great deal, from mild anxiety to very severe panic and
terror. While some people simply feel a bit nervous when they have to drive,
others can barely cope with the anxiety.

But there are also people who have full-scale panic
attacks at the wheel, and soon give up driving altogether because of the
terror that grips them when they try to do so.

In fact these frightening feelings are exactly the
same thing that ‘normal’ people feel in situations that really are dangerous.
Soldiers in a battle feel exactly that way. The only thing different about
a phobia, is that there is no logical reason for the fear.

But phobias aren’t just severe anxiety: the
anxiety is turned into a phobia by avoidance.

In the early stages of a driving phobia, the person
affected sometimes tries to overcome his or her fears head on, by brief
ventures into the feared situation, usually retreating instantly when anxiety
arises. This avoidance brings a reduction of the tension, and rapidly becomes
a habit, so that the next attempt becomes more difficult, and so on until
the attempts to face the problem stop altogether. Avoiding the situations
that make us feel frightened makes us more sensitive to those situations,
and ‘conditions’ us to fear them even more.

Avoidance is like retreating from an enemy. We may
feel safer to begin with, but we’re letting the enemy get us on the run.
And we have to retreat further and further, until we find that a huge slice
of our world has been grabbed away from us.

This is why phobias can be such a big problem. Because
we tend to avoid the things we fear, the fear can worsen very rapidly. To
recover, we need to put that process into reverse.

The fear reaction is virtually automatic, and very
difficult to control. In the early period of human development, it was a
useful survival trait: as a soft bodied species surrounded by predators,
we needed an instant response that would get us out of trouble, something
that would not allow our inquisitive brains to let us linger looking for
the cause. However, humans learn quickly and we can train ourselves to respond
positively to threats, and not to react with terror to things which prove,
with experience, to be harmless. Lion tamers, tight-rope walkers, scaffolders
and firemen have all learnt to handle potentially dangerous situations safely.
If this were not true, we would still be cowering in the backs of caves!

WHAT ARE THE SYMPTOMS OF PHOBIA?

Like other phobias, driving phobia can produce the
unpleasant physical symptoms of ‘normal’ fear:

heart palpitations

feeling sick

chest pains

difficulty breathing

dizziness

‘jelly legs’

feeling ‘unreal’

intense sweating

feeling faint

dry throat

restricted or ‘fuzzy’ vision or hearing.

In severe cases, people may feel certain that they
are about to die, go mad, or lose control of themselves and injure someone,
or do something disgusting and humiliating. Most of all they feel an overpowering
urge to ‘escape’ from the situation they are in. They also develop an acute
fear of repeating these very unpleasant experiences, and this is what really
gives the phobia its power.

Of course, these are feelings, not reality. The
plain truth is that even the worst panic attacks do not cause any long-term
ill-effects, and people simply do not die, go mad, or cause mayhem as a
result.

IT CAN’T JUST BE ANXIETY, CAN IT?

Someone with severe phobic symptoms has a ‘severe
anxiety condition’, which is much worse than just being nervous or ‘a bit
of a worrier’. Anxiety at this level can be as disabling as many physical
diseases. However, because it seems so silly to feel so awful in such ordinary
situations, many people look for a more ‘logical’ explanation.

Sometimes they convince themselves that they must
have a serious mental or physical illness, and become frequent visitors
to their doctor’s surgery. They may end up having a long series of medical
tests, all of which draw a blank.

So it is often a relief to learn that a phobia is
not a mental illness either, and that the bodily changes caused by severe
anxiety do indeed cause nasty symptoms which can seem like a serious disease.
However, this does not mean that a person with a phobic condition does not
also have a medical problem. This is one reason why we always recommend
phobics to keep in touch with their GP.

WHAT CAUSES DRIVING PHOBIA?

It’s hard to be precise, though sometimes an unpleasant
experience triggers it off. One Anxiety Care client became severely phobic
within a few days of making a long and dangerous night journey in thick
fog. Being in a bad road accident (or even just seeing one) can also be
the trigger.

On the other hand, lots of people find that their
driving phobia comes on gradually, or

comes and goes over a long period, and no particular
trigger is involved. It may just be anxiety focusing on a regular activity
as part of a generally rising anxiety state.

IS IT IMPORTANT TO FIND OUT THE CAUSE?

It may be useful to know the ‘cause’, but
it isn’t vital. Often, the origin of the phobia is nothing to do with driving,
but is part of a broader anxiety problem such as agoraphobia or general
anxiety disorder (GAD). A run of unpleasant ‘life events’ such as illness,
death of a close relative, marriage break-up, losing a job or bad depression
may lie behind it.

People who are recovering from driving phobia do
begin to talk more freely about driving, including accidents etc., but this
a sign of recovery, not a stage that has to be reached before recovery can
start.

In general it is not worth spending a lot of time
and energy on ‘rooting out the cause’. The point is to learn to control
the phobia.

HOW DOES DRIVING PHOBIA RELATE TO OTHER ANXIETY
CONDITIONS?

Driving phobia is sometimes part of the ‘agoraphobic
cluster’, in which case the person concerned is also likely to fear
standing in queues, going onto bridges, and being in places where they feel
‘trapped’ (such as a hair-dresser or a dentist).

People with these problems often find it difficult
to go out without a companion, for

fear of encountering such situations. They may also
have ‘social’ phobias, such as fear of blushing, trembling, talking, eating
or writing in front of other people, and of being stared at (though these
can also be separate phobias).

Some people with driving phobias have General
Anxiety Disorder (GAD), and feel anxious wherever they are. Many GAD
cases feel that they are going mad, but as with all phobias, this is not
mental illness and has nothing to do with insanity.

People with GAD may also worry excessively about
family health, the future etc., but they usually manage to face up to what
they fear and struggle on with life, even if they find this very difficult.

Depression can also lie behind driving phobia
and other anxiety conditions. To a person whose overall energy is lowered
by depression, the world is a very anxious place, where problems grow out
of all proportion.

Important: If someone is clinically depressed,
the general rule is for their doctor to treat the depression first, before
they go on to tackle the phobia. A person who is depressed, or who is taking
anti-depressant drugs, is unlikely to be able to undertake a successful
programme of self-treatment for their phobia, or may find it very difficult.

HOW CAN I OVERCOME MY PHOBIA?

People with phobias have become ‘conditioned’ to
produce the fear reaction in situations which aren’t really dangerous at
all. The best way to counter this is by ‘de-conditioning’: training themselves
to react correctly. This is done by gradually exposing themselves to the
things they fear, and experiencing the fears without running away, and so
becoming less sensitive to them.

The idea is simple, and it does not necessarily
require the help of professionals, but it calls for a fair amount of courage
and determination. The help of family and friends can make self-treatment
much easier to manage, and this is also why many people prefer to join a
self-help group where they can get support from people in a similar situation.

Anyone who decides to try desensitisation needs
to draw up a personal ‘training programme’. This means deciding where they
are now, and where they want to be at the end, and fitting as many gradual
‘exposure’ steps in between as they need.

The first step can be as simple as staying in a
situation that can just be managed now, but for a little longer than before.

Obviously people’s phobias are at many different
levels and may focus on many different fears, but here is one example of
how self-exposure steps for a driving phobia could be ‘graded’:

Stage 1: Sit in the car with the engine running.

Stage 2: Drive a few yards up the road and then
park, switch off, and walk back.

Stage 3: Drive round the block, then park, switch
off, etc.

Stage 4: Take a slightly longer trip with a
companion to support you.

Stage 5: Take the same trip without the companion.

Stage 6: Take a still longer trip.

Stage 7: Drive on a ‘trapping’ road such as
a motorway, with a companion.

Stage 8: Try the motorway trip without a companion.

Stage 9: Take a long trip on roads that you
are unfamiliar with.

The steps can be as large or as small as necessary,
and big steps can be broken down into smaller ones. But each step should
challenge the anxiety a little more than the last.

Relaxation techniques can be helpful in tackling
the next step, and it is easy to practice relaxation in the seclusion of
a car. But if the steps you have chosen prove impossible, of if you are
depressed or have other severe anxiety problems, then professional help
from a clinical psychologist or psychiatrist may be needed.

You can reach such professionals through your GP;
and in any case we recommend that you contact your GP and talk to him or
her about your disorder.

The basic reference work on which we have drawn is Fears, Phobias and
Rituals by Professor I M Marks, published by Oxford University Press (1987)